Surgical Table with Patient Support Having Flexible Inner Frame Supported on Rigid Outer Frame

ABSTRACT

A surgical table comprising a base and a patient support supported between opposed ends of the base, each opposed end including a pitch/roll assembly. The base is configured such that the patient support can be rolled and pitched relative to the opposed ends via the pitch/roll assemblies such that the roll axis of each pitch/roll assembly remains coaxial regardless of how the patient support is pitched or rolled relative to the base. The patient support includes an outer frame and an inner frame supported on, and displaceable relative to, the outer frame. The inner frame is further articulating about, and relative to, itself. The outer frame is rigid in that it does not change configurations.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application claims priority under 35 U.S.C. §119 to U.S.Provisional Patent Application No. 62/021,481, filed on Jul. 7, 2014,titled “RADIOLUCENT HINGE FOR A SURGICAL TABLE”, which is herebyincorporated by reference in its entirety into the present application.

The present application claims priority under 35 U.S.C. §119 to U.S.Provisional Patent Application No. 62/118,282, filed on Feb. 19, 2015,titled “RADIOLUCENT HINGE FOR A SURGICAL TABLE”, which is herebyincorporated by reference in its entirety into the present application.

The present application claims priority under 35 U.S.C. §119 to U.S.Provisional Patent Application No. 62/118,305, filed on Feb. 19, 2015,titled “SINGLE COLUMN PATIENT POSITIONING AND SUPPORT STRUCTURE”, whichis hereby incorporated by reference in its entirety into the presentapplication.

The present application claims priority under 35 U.S.C. §119 to U.S.Provisional Patent Application No. 62/021,630, filed on Jul. 7, 2014,titled “SURGICAL TABLE WITH PATIENT SUPPORT HAVING FLEXIBLE INNER FRAMESUPPORTED ON RIGID OUTER FRAME”, which is hereby incorporated byreference in its entirety into the present application.

The present application claims priority under 35 U.S.C. §119 to U.S.Provisional Patent Application No. 62/021,643, filed on Jul. 7, 2014,titled “SINGLE COLUMN PATIENT POSITIONING SUPPORT STRUCTURE”, which ishereby incorporated by reference in its entirety into the presentapplication.

The present application claims priority under 35 U.S.C. §119 to U.S.Provisional Patent Application No. 62/021,595, filed on Jul. 7, 2014,titled “PATIENT SUPPORT STRUCTURE WITH PIVOTING AND TRANSLATING HINGE”,which is hereby incorporated by reference in its entirety into thepresent application.

TECHNICAL FIELD

The present disclosure generally relates to surgical tables andassociated methods. More specifically, the present disclosure relates topatient positionable surgical tables and associated methods.

BACKGROUND OF THE INVENTION

Current surgical approaches often utilize surgical procedures involvingmultiple access angles to a surgical site. For example, some surgicalprocedures move the patient to different positions (e.g. Trendelenburg,reverse Trendelenburg, supine, prone, lateral-decibitus, etc.)throughout the procedure to access the surgical site from differentangles. Further, some surgical procedures, such as spinal surgery, mayinvolve access through more than one surgical site. Because these sitesmay not be in the same plane or anatomical location, the patient needsto be moved to and supported in different positions throughout theprocedure. However, many conventional tables providing adjustablepositions have excessive movement of the table base and are overly largewith respect to floor space. Further, many conventional tables havecomplex and expensive mechanical arrangements.

It is with these observations in mind, among others, that variousaspects of the present disclosure were conceived and developed.

SUMMARY OF THE INVENTION

Disclosed herein is a surgical table comprising a base and a patientsupport supported between opposed ends of the base, each opposed endincluding a pitch/roll assembly. The base is configured such that thepatient support can be rolled and pitched relative to the opposed endsvia the pitch/roll assemblies such that the roll axis of each pitch/rollassembly remains coaxial regardless of how the patient support ispitched or rolled relative to the base. The patient support includes anouter frame and an inner frame supported on, and displaceable relativeto, the outer frame. The inner frame is further articulating about, andrelative to, itself. The outer frame is rigid in that it does not changeconfigurations.

Aspects of the present disclosure involve a surgical table forsupporting and positioning a patient above a floor. The surgical tablemay include a base and a patient support. The base may be supported onthe floor and may include a first end support and a second end supportopposite the first end support. The patient support may include alongitudinal axis, an outer frame, and an inner frame moveably coupledwith the outer frame at a hinge having an axis of rotation that istransverse to the longitudinal axis. The outer frame may include a firstend operably coupled with the first end support and a second endoperably coupled with the second end support. The axis of rotation maybe configured to displace in a direction of the longitudinal axisbetween the first end and the second end when the inner framearticulates relative to the outer frame.

Aspects of the present disclosure may also involve a surgical table forsupporting and positioning a patient above a floor. The surgical tablemay include a base and a patient support. The base may be supported onthe floor and may include a first end support and a second end supportopposite the first end support. The patient support may include alongitudinal axis, an outer frame, an inner frame moveably coupled withthe outer frame at a hinge having an axis of rotation that is transverseto the longitudinal axis, and a drive assembly. The outer frame mayinclude a first end operably coupled with the first end support and asecond end operably coupled with the second end support. The inner framemay include an upper leg member coupled with a lower leg member at anarticulating joint. The drive assembly may include at least one motorconfigured to displace the inner frame relative to the outer frame andarticulate the upper leg member relative to the lower leg member.

Aspects of the present disclosure may also involve a base for a surgicaltable for supporting and positioning a patient above a floor. The basemay include a first end support and a second end support opposing thefirst end support. A patient support structure may be coupled with thefirst end support via a first connection assembly that includes a firstroll assembly and a first pitch assembly. The patient support may becoupled with the second end support via a second connection assemblythat includes a second roll assembly and a second pitch assembly. Thepatient support may be configured to roll about a roll axis via thefirst and second roll assemblies. The pitch assemblies may be configuredto actively maintain coaxial alignment of the first and second rollassemblies by pitching or angling the first and second roll assembliesupward or downward when the first or second end supports changeelevation relative to each other. Each of the pitch assemblies mayinclude at least one linear drive to actively maintain the coaxialalignment.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and further features, advantages and benefits of the inventionwill be apparent upon consideration of the descriptions herein taken inconjunction with the accompanying drawings, in which:

FIG. 1 is an isometric view from a right side and head end perspectiveof an embodiment of a surgical table with a patient supported thereon ina prone position and an inner frame of the patient support in a neutralposition;

FIG. 2 is an isometric view from a left side and foot end perspective ofthe surgical table and patient of FIG. 1;

FIG. 3 is a right side elevation of the surgical table and patient ofFIG. 1;

FIG. 4 is a left side elevation of the surgical table and patient ofFIG. 1;

FIG. 5 is an isometric view from a right side and head end perspectiveof the base of the surgical table of FIG. 1.

FIG. 6 is an isometric view from a left side and foot end perspective ofthe base of FIG. 5;

FIG. 7 is a right side elevation of the base of FIG. 5;

FIG. 8 is a right side isometric view of a front region of the head endof the base of FIG. 1;

FIG. 9 is a left side isometric view of the front region of the head endof FIG. 8;

FIG. 10 is an exploded left side isometric view of the front region ofthe head end of FIG. 8;

FIG. 11 is an elevation view of a rear region of the head end of FIG. 8;

FIG. 12 is a right side isometric view of an upper rear region of thehead end of FIG. 11;

FIG. 13 is a left side isometric view of the upper rear region of thehead end of FIG. 11;

FIG. 14 is the same view as FIG. 13, except the top plate of the mountsupporting the head end pitch/roll assembly has been hidden to moreclearly depict components of the head end translation assembly;

FIG. 15 is a right side isometric view of a front region of the head endpitch/roll assembly of the base of FIG. 1;

FIG. 16 is a left side isometric view of the front region of the headend pitch/roll assembly of FIG. 15;

FIG. 17 is an exploded right side isometric view of the rear region ofthe head end pitch/roll assembly and the head end translation assembly;

FIG. 18 is a horizontal cross section focusing on the pivot assembly astaken along section line 18-18 in FIG. 13;

FIG. 19 is the same isometric view as FIG. 16, except the ladderattachment assembly has been removed from about the axel;

FIG. 20 is a cross sectional isometric elevation focusing on the rollassembly as taken along section line 20-20 in FIG. 15;

FIG. 21 is a cross sectional isometric elevation focusing on the wormdrive assembly as taken along section line 21-21 in FIG. 19;

FIG. 22 is a right side isometric view of a front region of the foot endof the base 15 of FIG. 1;

FIG. 23 is a left side isometric view of a front region of the foot endof FIG. 22;

FIG. 24 is a left side isometric view of a rear region of the verticalsupport of the foot end of the base;

FIG. 25 is the same view as FIG. 24, except with the top plate of themount supporting the foot end pitch/roll assembly removed to moreclearly depict components of the foot end translation assembly;

FIG. 26 is a horizontal cross section focused on the pitch assembly astaken along section line 26-26 in FIG. 24;

FIG. 27 is a cross sectional isometric elevation focused on the rollassembly as taken along section line 27-27 in FIG. 23;

FIG. 28 is an isometric view from a left side and head end perspectiveof a patient support of the table of FIGS. 1-4, wherein the inner frameis in a neutral position relative to the outer frame;

FIG. 29 is the same view of the patient support depicted in FIG. 28,except shown exploded;

FIG. 30 is an exploded isometric view from a right side and foot endperspective of the patient support of FIG. 28;

FIG. 31 is an exploded isometric view of the drive assemblies, innerframe and the depressed regions of the side structures of the outerframe as viewed from a right side and head end perspective, wherein theinner frame is in an elevated position relative to the outer frame;

FIG. 32 is an exploded isometric view of the linear drive assembly asviewed from a right side and foot end perspective.

FIG. 33A is the same view as FIG. 31, except in an assembled state;

FIGS. 33B-33C are the same view as FIG. 33A, except illustrating theinner frame in neutral and lowered positions relative to the outerframe, respectively;

FIGS. 34A-34C illustrate same respective conditions and essentially thesame components as FIGS. 33A-33C, except from a lower perspective;

FIG. 35 is an enlarged view of the exploded rotation drive assemblyillustrated in FIG. 29.

FIGS. 36A-36B are of the same view as FIG. 1, except, instead of theinner frame being in a neutral position as depicted in FIG. 1, the innerframe is in an elevated position and a lowered position, respectively;

FIGS. 37A-37B are of the same view as FIG. 2, except, instead of theinner frame being in a neutral position as depicted in FIG. 2, the innerframe is in an elevated position and a lowered position, respectively;

FIGS. 38A-38B are of the same view as FIG. 3, except, instead of theinner frame being in a neutral position as depicted in FIG. 3, the innerframe is in an elevated position and a lowered position, respectively;

FIGS. 39A-39C are of the same view as FIG. 1, except only depicting thepatient support and H-frames, with the inner frame shown in the elevatedposition, the neutral position and the lower position, respectively;

FIGS. 40A-40C are of the same view as FIG. 2, except only depicting thepatient support and H-frames, with the inner frame shown in the elevatedposition, the neutral position and the lower position, respectively;

FIGS. 41A-41C are of the same view as FIG. 3, except only depicting thepatient support and H-frames, with the inner frame shown in the elevatedposition, the neutral position and the lower position, respectively

FIGS. 42A-42C are right side elevation views of the right recessedregion of the outer frame and corresponding right drive assembly, linkarm, and inner frame components, the inner frame depicted in theelevated position, the neutral position and the lower position,respectively;

FIGS. 43A-43C are right side elevation views of the left recessed regionof the outer frame and corresponding left drive assembly, link arm, andinner frame components, the inner frame depicted in the elevatedposition, the neutral position and the lower position, respectively;

FIG. 44 is an isometric view from a right side and head end perspectiveof an embodiment of the surgical table with the patient supportpositioned with flat-top pads to position a patient in a seatedposition.

FIG. 45 is an isometric view from a left side and foot end perspectiveof the surgical table as shown in FIG. 44.

FIG. 46 is a right side view of the surgical table as shown in FIG. 44.

FIG. 47 is an isometric view from a right side and a head endperspective of an embodiment of the surgical table with the patientsupport in Trendelenburg with a partial roll around a longitudinal axisof the patient support.

FIG. 48 is an isometric view from a left side and foot end perspectiveof the surgical table as shown in FIG. 47.

FIG. 49 is a right side view of the surgical table as shown in FIG. 47.

FIG. 50 is an isometric view from a right side and a head endperspective of an embodiment of the surgical table with the patientsupport in a partial rolled position.

FIG. 51 is a left side view of the surgical table as shown in FIG. 50.

FIG. 52 is right side view of the surgical table as shown in FIG. 50.

FIG. 53 illustrates a computer operation.

FIG. 54 illustrates a diagrammatic depiction of a computer system forimplementing the computer operation of FIG. 53.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Disclosed herein is a surgical table 10 comprising a base 15 and apatient support 20 supported between opposed ends of the base, eachopposed end including a pitch/roll assembly. The base is configured suchthat the patient support can be rolled and pitched relative to theopposed ends via the pitch/roll assemblies such that the roll axis ofeach pitch/roll assembly remains coaxial regardless of how the patientsupport is pitched or rolled relative to the base. The patient supportincludes an outer frame and an inner frame supported on, anddisplaceable relative to, the outer frame. The inner frame is furtherarticulating about, and relative to, itself. The outer frame is rigid inthat it does not change configurations. The surgical table 10 isadvantageous for a number of reasons, including, but not limited to,having decreased floor space requirements, being less expensive tobuild, and providing a wide range of patient positions and the abilityto transition between those positions while maintaining the surgicalsite steady.

To begin the detailed discussion of an embodiment of the surgical table10, reference is made to FIGS. 1-4. FIG. 1 is an isometric view from aright side and head end perspective of an embodiment of the surgicaltable 10 with a patient 12 supported thereon in a prone position. FIG. 2is an isometric view from a left side and foot end perspective of thesurgical table 10 and patient 12 of FIG. 1. FIGS. 3 and 4 are,respectively, a right side elevation and a left side elevation of thesurgical table 10 and patient 12 of FIG. 1.

As shown in FIGS. 1-4, the table 10 includes a base 15 and a patientsupport 20. The base 15 supports the patient support 20 above a floorsurface 25 on which the base 15 rests. The table 10 includes a head end30, foot end 35, a right patient side 40 and a left patient side 45,each patient side 40, 45 of the table 10 corresponding to an adjacentside of the patient 12 when the patient 12 is laying prone on thepatient support 20, as can be understood from FIGS. 1-4. Thedesignations of the sides 40, 45 as being right or left have no meaningother than for purposes of facilitating the discussion herein.

As illustrated in FIGS. 1-4, a head end 55 of the patient support 20 iscoupled to a head end 60 of the base 15, and a foot end 65 of thepatient support 20 is coupled to a foot end 70 of the base 15. Thus, thepatient support 20 extends lengthwise between the head and foot ends 60,70 of the base 15. Further, the patient support 20 and base 15 areconfigured such that the patient support can both roll and pitch betweenthe head and foot ends 60, 70 of the base 15, as discussed in detailbelow.

I. The Base

To begin the detailed discussion of the base 15, reference is made toFIGS. 5-7, wherein FIG. 5 is an isometric view from a right side andhead end perspective of the base 15 of the surgical table 10 of FIG. 1,FIG. 6 is an isometric view from a left side and foot end perspective ofthe base 15 of FIG. 5, and FIG. 7 is a right side elevation of the base15 of FIG. 5. As shown in FIGS. 5-7, the base head end 60 includes avertical support or column 100, a wheeled base 105 with castors 110, acomputer 115, a control box 120, a head end translation assembly 125,and a head end pitch/roll assembly 130. Similarly, the base foot end 70includes a vertical support 100, a wheeled base 105 with castors 110, afoot end translation assembly 135, and a foot end pitch/roll assembly140.

As illustrated in FIG. 7, the wheeled bases 105 are supported above thefloor surface 25 via their respective castors 110. The castors 110facilitate the base 15 being rolled along the floor surface 25 and maybe of a lockable variety thereby allowing the base 15 to be fixedlylocated on the floor surface 25.

As depicted in FIGS. 5-7, the wheeled bases 105 are coupled together viaa base frame member 142 that extends longitudinally between the opposedwheeled bases 105. The base frame member 142 may be tubular or any otherstructural shape. Depending on the embodiment, the base frame member 142may be permanently fixed with respect to its overall length or the baseframe member 142 may be adjustable relative to its overall length toallow the opposed wheeled bases 105 to be moved closer together tofacilitate a reduced floor footprint of the base 15, therebyfacilitating the storage of the base 15. In such an adjustableembodiment, the base frame member 142 may be telescopically configuredto allow the opposed wheeled bases 105 to move towards each other forstorage of the base 15. Depending on the embodiment, the adjustable baseframe member 142 may be manually adjusted or may be equipped with apowered drive mechanism for adjusting the base frame member 142 withrespect to its length.

While the base frame member 142 may or may not be adjustable, it shouldbe noted that the base 15 and the patient support 20 used therewith areconfigured such that the patient may be pitched head down(Trendelenburg), pitched head up (reverse Trendelenburg), rolled rightor left, placed in a neutral position, flexed, extended or anycombination of the aforementioned positions without the opposed wheeledbases 105 and their associated vertical supports 100 displacing relativeto each other. In other words, when the patient is moved through a rangeof positions on the surgical table 10, the vertical supports 100 willremain fixed relative to each other whatever that range of positions maybe. The mechanical arrangements for facilitating such patientdisplacement while maintaining the vertical supports 100 fixed relativeto each other are discussed in detail below.

As indicated in FIGS. 5-7, each vertical support or end support 100extends vertically upward from its respective wheeled support 105. Asdiscussed in greater detail below, each vertical support 100 isvertically adjustable in height and may be actuated to evenly displacetogether or displace differing amounts and/or directions relative toeach other at the same time or during individual times.

The control box 120 extends vertically upward from the wheeled base 105,and the computer 115 is supported on a top surface of the control box120. The control box 120 contains electrical wiring, junctions, andother related electrical circuitry associated with the operation andcontrol of the surgical table function directed by the software andcentral processing unit of the computer according to operator inputsentered into the computer 115 via its user interface, which may be inthe form of a touch screen 145 of the computer 115.

The head end pitch/roll assembly 130 and the foot end pitch/rollassembly 140 are moveably attached to their respective vertical supports100 so as to facilitate both pitch and roll of the patient support 20 asdescribed in detail below. As can be understood from FIG. 7, the headend pitch/roll assembly 130 includes a roll axis A, and the foot endpitch/roll assembly 140 includes a roll axis B. As described in detailbelow, through a combination of mechanical, electrical and softwarearrangements, these axes A, B may be automatically maintained coaxialwith each other through the range of possible patient displacementsprovided for by the mechanical arrangement of the pitch/roll assemblies130, 140, the vertical supports 100, and the patient support 20.

As described in detail below, the head end translation assembly 125 andfoot end translation assembly 135 are each configured to provide forlongitudinal displacement of the respective pitch/roll assembly 130, 140along the longitudinal axis of the base 15 and relative to therespective vertical support 100 on which the pitch/roll assembly ismounted. In other words, this longitudinal displacement via the head endtranslation assembly 125 causes the head end pitch/roll assembly 130 tomove relative to its vertical support 100 closer or further away fromthe vertical support 100 of the foot end 70. Similarly, thislongitudinal displacement via the foot end translation assembly 135causes the foot end pitch/roll assembly 140 to move relative to itsvertical support 100 closer or further away from the vertical support100 of the head end 60. Thus, as further described below, thetranslation assemblies 125, 135 work together to compensate for thechange in effective distance between the pitch/roll assemblies 130, 140brought about by a rigid exterior frame 300 of the patient support 20changing slope from a horizontal orientation between the opposedvertical supports 100 and a sloped orientation between the opposedvertical supports 100 and vice versa. Because the translation assemblies125, 135 compensate for such movement of the rigid exterior frame 300,the opposed columns 100 can remain a fixed distance from each otherwhile the exterior rigid frame transitions between horizontal andvarying degree of slope, and vice versa.

As will be discussed below in detail, the mechanical configurations ofthe table 10, namely, the rotation/pitch assemblies 130, 140 and thetranslation assemblies 125, 135 of the base 15, plus the displacementscapability of the inner frame 302 relative to the outer frame 300 of thepatient platform 20, combine to make possible articulations anddisplacements of the patient that keep the surgical field (e.g., thelumbar spine) stable in relation to the floor 25 such that the surgicalfield does not move up or down or cephalad or caudad in relation to thefloor during the articulations or displacements unless the operatorpurposely intends the surgical field to move up or down or cephalad orcaudad in relation to the floor during the articulations ordisplacements. The coordinated actuation and movement of the mechanicalconfigurations of the base 15 and patient support 20 that allow thepatient to be rolled, pitched, flexed, extended, held neutral, etc.while maintaining a stable surgical field are facilitated by softwaredriving the servomotors of the various mechanical arrangements of thetable, these servomotors being software synchronized and linked withposition and limit-stop sensors.

a. The Head End of the Base

To begin the detailed discussion of the head end 60 of the base 15,reference is made to FIGS. 8-10, wherein FIGS. 8-10 are, respectively, aright side isometric view, a left side isometric view, and an explodedleft side isometric view of a front region of the head end 60 of thebase 15 of FIG. 1. The designations of the head end 60 having front andrear regions have no meaning other than for purposes of facilitating thediscussion herein.

As mentioned above and further shown in FIGS. 8-10, the base head end 60includes the vertical support 100, the wheeled base 105 with castors110, the computer 115, the control box 120, the head end translationassembly 125, and the head end pitch/roll assembly 130. The head endvertical support 100 of the base 15 extends vertically upward from thewheeled base 105 and is generally centered right-to-left on the wheeledbase 105 and centered right-to-left relative to the base frame member142. The control box 120 also extends vertically upward from the wheeledbased 105 and is to the left of the head end vertical support 100. Thecomputer 115 is supported on the control box 120. The head endtranslation assembly 125 and the head end pitch/roll assembly 130 arefound near the top of the head end vertical support 100.

1. The Head End Vertical Support

FIGS. 11-13 are, respectively, a rear elevation view, a right sideisometric view, and a left side isometric view of a rear region of thevertical support 100 of the head end 60 of the base 15. As can beunderstood from FIGS. 7 and 11-13, in one embodiment, the head endvertical support 100 includes a telescopic arrangement of an outersegment 150, an intermediate segment 152 within the outer segment 150,and an inner segment 154 within the intermediate segment 152. The bottomend of the outer segment 150 is fixedly connected to the wheel base 105,the intermediate segment 152 is vertically displaceable along the outersegment 150, and the inner segment 154 is vertically displaceable alongthe intermediate segment 152. A top end of the inner segment 154 isfixedly connected to a base plate 156 of the head end translationassembly 125, and the head end translation assembly 125 is fixedlyconnected to a top plate 158 of a mount 160 supporting the head endpitch/roll assembly 130. In other words, the head end translationassembly 125 is sandwiched between the top end of the head end verticalsupport 100 and the mount 160 supporting the head end pitch/rollassembly 130 thereby facilitating the front/rear displacement of thehead end pitch/roll assembly 130 along the longitudinal axis of the base15 relative to the head end vertical support 100, as described ingreater detail below. Also, since the top end of the inner segment 154is coupled to the head end pitch/roll assembly 130 via the sandwichedarrangement of the top plate 158, head end translation assembly 125 andmount 160, the head end pitch/roll assembly 130 is verticallydisplaceable via the head end vertical support 100 relative to the headend wheeled base 105.

The vertical displacement of the intermediate segment 152 and the innersegment 154 may be brought about by a variety of mechanical arrangementsacting on the segments including, but not limited to, screw drivenlinear actuators, rack and pinion arrangements, hydraulic or pneumaticrams, etc. While the segments 150, 152, 154 are depicted as beingtelescopically arranged, the segments may have other configurations solong as the segments facilitate the head end vertical support 100vertically adjusting so as to be adjustable in its overall height. Inone embodiment, the head end vertical support 100 may be heightadjustable up to approximately 37 inches in total adjustment. In oneembodiment, the height adjustment may be infinitely adjustable such thatthe adjustments are not incremental. In other embodiments, the heightadjustment may be incrementally adjustable such that the heightadjustments are divided over a set number of increments. In someembodiments, the height adjustment may be selectively available aseither infinitely adjustable or incrementally adjustable as a functionof software operation and selections made by an operator of the table atthe computer interface screen 145.

2. The Head End Translation Assembly

As indicated in FIG. 14, which is the same view as FIG. 13, except withthe top plate 158 of the mount 160 supporting the head end pitch/rollassembly 130 removed to more clearly depict components of the head endtranslation assembly 125, the assembly 125 includes the base plate 156,rails 164, slotted blocks 166, and a linear actuator 168. The rails 164are fixedly connected to the base plate 156, which is fixedly connectedto the top end of the inner segment 154 of the head end vertical support100. The slotted blocks 166 are each coupled to a respective rail 164 ina sliding arrangement such that each slotted block 166 slides along itsrespective rail 164. The slotted blocks are also fixedly connected tothe bottom surface of the top plate 158 of the mount 160 supporting thehead end pitch/roll assembly 130. Thus, the sliding block/railarrangement of the head end translation assembly 125 is sandwichedbetween the base plate 156 (which is fixedly connected to the top end ofthe head end vertical support 100) and the top plate 158 of the mount160 supporting the head end pitch/roll assembly 130 thereby facilitatingthe front/rear displacement of the head end pitch/roll assembly 130along the longitudinal axis of the base 15 relative to the head endvertical support 100. In one embodiment, this displacement is mechanizedvia a linear actuator 168 that driven by a motor 170 and acts betweenthe base plate 156 of the head end translation assembly 125 and themount 160 supporting the head end pitch/roll assembly 130.

The translation assemblies 125, 135 work together to compensate for thechange in effective distance between the pitch/roll assemblies 130, 140brought about by the rigid exterior frame 300 of the patient support 20changing slope from a horizontal orientation between the opposedvertical supports 100 and a sloped orientation between the opposedvertical supports 100 and vice versa. Because the translation assemblies125, 135 compensate for such movement of the exterior rigid frame, theopposed columns 100 can remain a fixed distance from each other whilethe rigid exterior frame 300 transitions between horizontal and varyingdegree of slope, and vice versa.

In other words, because the length of the rigid exterior frame 300 ofthe patient support 20 is fixed, when the exterior rigid frame ishorizontal as shown in FIG. 3, the pitch/roll assemblies 130, 140 willbe at their further distance apart, the slotted blocks 166 of therespective translation assemblies 125, 135 having displaced theirgreatest extent apart along their rails 164. Thus, the top plates 158 ofthe mounts 160 supporting the respective pitch/roll assemblies 130/140will move away from each other (i.e., diverge) as indicated by arrows Ain FIGS. 13 and 24.

As the rigid exterior frame 300 of the patient support 20 transitions toan increasingly sloped orientation (e.g., as depicted in FIGS. 44-46),the distance between the pitch/roll assemblies 130, 140 will have todecrease as the sloped length of the exterior rigid frame is ahypotenuse of a triangle and the horizontal distance between thepitch/roll assemblies is a base of the triangle and, as a result, lessthan the hypotenuse. Thus, when the rigid exterior frame 300 of thepatient support 20 is at its maximum slope, the pitch/roll assemblies130, 140 will be at their smallest distance apart, the slotted blocks166 of the respective translation assemblies 125, 135 having displacedtowards each other to the greatest extent along their rails 164. Thus,the top plates 158 of the mounts 160 supporting the respectivepitch/roll assemblies 130/140 will move towards each other (i.e.,converge) as indicated by arrows B in FIGS. 13 and 24.

The head end translation assembly 125 is also present and configured tofacilitate the surgical field being held stable during the variousmanipulations of the surgical field by the patient support 20 beingdisplaced relative to the base 15 and/or the patient 12 being flexed,extended or placed neutral by the deflection of the patient supportinner frame 302 relative to the patient support outer frame 300, asdiscussed below. The head end and foot end translation assemblies 125,135 are coordinated in this function by software driving the servomotorsof the translation assemblies 125, 135.

3. The Head End Pitch/Roll Assembly

To begin a detailed discussion of the head end pitch/roll assembly 130of the base 15 of FIG. 1, reference is made to FIGS. 15-17. The head endpitch/roll assembly 130 may also be called a first connection assembly.FIGS. 15-16 are, respectively, right and left side isometric views ofthe front region of the head end pitch/roll assembly 130 of the base 15of FIG. 1. FIG. 17 is an exploded right side isometric view of the rearregion of the head end pitch/roll assembly 130 and the head endtranslation assembly 125. As can be understood from FIGS. 10 and 15-17,the head end pitch/roll assembly 130 includes a pitch assembly 172pivotally connected to the mount 160 and a roll assembly 174 pivotallycoupled to an arm or yoke 176 of the pitch assembly 172.

The pitch assembly 172 includes the pitch arm 176 and a linear drive 178having a motor 180. As indicated in FIG. 18, which is a horizontal crosssection focused on the pitch assembly 172 as taken along section line18-18 in FIG. 13, forward or fulcrum pins 182 extend from the right andleft sides of the mount 160 to be pivotally received by pivot holes 184in the right and left sides of the pitch arm 176 to combine together asfulcrums or pivots 185 (see FIG. 17) about which the pitch arm 176pivots relative to the mount 160, as indicated by arrows C in FIGS. 15and 16.

Rearward or lever arm pins 186 extend from the right and left sides ofthe pitch arm 176 rearward of the fulcrum pins 182 to be pivotallyreceived by the upper ends of the linear drives 178, thereby forminglever points 187 (see FIG. 17) to act about the fulcrums 185. Bottomends of the linear drives 178 are pinned via anchor pins 188 to a bottomregion of each respective side of the mount 160, thereby forming anchorpoints 189 (see FIG. 17).

Thus, when the linear drives 178 act between their respective anchorpins 188 (or anchor points 189) and lever arm pins 186 (or lever points187) such that the linear drive 178 extends, the pitch arm 176 is causedto pitch downward about the fulcrum pins 182 (or fulcrums 185), therebydriving the roll assembly 174 to pitch downward as indicated by arrow Din FIG. 15. Similarly, when the linear drives 178 act between theirrespective anchor pins 188 (or anchor points 189) and lever arm pins 186(or lever points 187) such that the linear drive 178 retracts, the pitcharm 176 is caused to pitch upward about the fulcrum pins 182 (orfulcrums 185), thereby driving the roll assembly 174 to pitch upwardlyas indicated by arrow E in FIG. 16.

As can be understood from FIGS. 10 and 15-17, the roll assembly 174includes a worm drive 190 including a worm 191 and a worm gear 192, theworm drive being driven by a motor 194. The roll assembly 174 furtherincludes an axel 196 that extends rearward from a center of a ladderattachment assembly 198. The ladder attachment assembly 198 includesupper and lower horizontal slots 200, each such slot including a pair ofspaced-apart hooked attachment mechanisms 202 that retain a horizontalbar 204 of an H-frame 206 received in the respective slot 200, as can beunderstood from FIG. 10.

The H-frame 206 is used to suspend the head end 55 of the patientplatform 20 from the head end 60 of the base 15, as can be understoodfrom FIGS. 3 and 4. More specifically, the H-frame 206 is used to linkthe head end 55 of the platform 20 to the ladder attachment assembly 198of the roll assembly 174 of the head end 60 of the base 15. The upper ofthe two horizontal bars 204 of the H-frame 206 is received in the lowerof the two horizontal slots 200 of the ladder attachment assembly 198and fixedly retained therein by the corresponding spaced-apart hookedattachments mechanism 202 and the interaction of tabs 208 of the H-frame206 received in corresponding notches 210 in the ladder attachmentassembly 198, as can be understood from FIGS. 10 and 15-17. As discussedbelow, the head end 55 of the platform 20 is pivotally coupled to thelower of the two horizontal bars 204 of the H-frame 206 such that thehead end 55 of the platform 20 can pivot about the lower of the twohorizontal bars 204 of the H-frame 206 when the platform 20 transitionsbetween different pitches.

An upper H-frame 206 (not shown in drawings) can be attached to theupper of the two horizontal slots 200 similar, but oppositely, as shownin the drawings for the lower H-frame 206. The presence of both an upperand lower H-frame 206 extending, respectively, upwardly and downwardlyfrom the ladder attachment assembly 198 of each end 60, 70 of the frame15 can be used to support an upper patient platform (not shown indrawings) and a lower patient platform 20 for to sandwich the patient 12there between for different procedures, positions, and movements,including tilting or even rolling of the patient 12.

FIG. 19 is the same isometric view as FIG. 16, except the ladderattachment assembly 198 has been removed from about the axel 196. FIG.20 is a cross sectional isometric elevation focused on the roll assembly174 as taken along section line 20-20 in FIG. 15. As can be understoodfrom FIGS. 10 and 17-20, the axel 196 extends rearward from a center ofthe ladder attachment assembly 198 such that a rearward half of the axel196 is pivotally supported by front and rear bearing rings 212 in acylindrical opening 214 of a front portion 216 of the pitch arm 176.Thus, the axel 196 is pivotally supported in, and relative to, the frontportion 216 of the pitch arm 176. The ladder attachment assembly 198 isfixed to the front end of the axel 196 and, as a result, is pivotalrelative to the front portion 216 of the pitch arm 176.

FIG. 21 is a cross sectional isometric elevation focused on the wormdrive 190 as taken along section line 21-21 in FIG. 19. As can beunderstood from FIGS. 17-21, the worm gear 192 is fixed to and extendsradially outward from the axel 196 to interface with the worm 191. Thus,the motor 194 of the worm drive 190 can drive the worm 191 in a firstdirection to cause the worm gear 192 and the axel 196 to displace in afirst rotation to cause the ladder attachment assembly 198 and thepatient platform 20 to pivot in a first roll direction. Similarly butoppositely the motor 194 of the worm drive 190 can drive the worm 191 ina second direction to cause the worm gear 192 and the axel 196 todisplace in a second rotation to cause the ladder attachment assembly198 and the patient platform 20 to pivot in a second roll direction. Theresulting first and second roll directions can be understood from arrowF in FIGS. 15 and 16. Depending on the embodiment, the mechanicalarrangement may allow for powered roll in either direction ofapproximately 25 degrees (plus or minus five degrees) for a total of 50degrees (plus or minus 10 degrees) of roll range right to left.

As shown in FIGS. 15-21, a window 218 is defined in the upper frontregion of the mount 160 to facilitate pitch clearance for the frontportion 216 of the pitch arm 176 as the pitch arm is cause to pitch upand down.

As can be understood from FIGS. 15-21, a roll lock assembly 220including a lock pin 222 can be received in one of a series of holesabout the circumference of the axel 196 to lock the axel 196 and, as aresult, the patient support 20 in a desired roll orientation. Dependingon the embodiment, the roll lock assembly 220 may be configured forautomated or manual actuation of the lock pin 222. While the rollassembly is configured for a total roll range right-to-left ofapproximately 50 degrees via power applied via the motor 194, the lockpin 222 can be disengaged to allow the patient platform 20 to be rolled180 degrees or even 360 degrees on the roll assemblies by surgical roomstaff physically and manually grasping the patient platform and rollingit relative to the base 15 to perform a sandwich and roll operation withthe patient on the patient platform. Once the sandwich and rolloperation is complete, the lock pin 222 can be re-engaged with the rollassembly to allow the roll assembly to be power driven again by themotor 194. Depending on the embodiment, the lock pin 222 may be locatedat only one of the ends of the base or at both ends of the base.

b. The Foot End of the Base

To begin the detailed discussion of the foot end 70 of the base 15,reference is made to FIGS. 22-23, wherein FIGS. 22-23 are, respectively,a right side isometric view and a left side isometric view of a frontregion of the foot end 70 of the base 15 of FIG. 1. The designations ofthe foot end 70 having front and rear regions have no meaning other thanfor purposes of facilitating the discussion herein.

As mentioned above and further shown in FIGS. 22-23, the base foot end70 includes the vertical support 100, the wheeled base 105 with castors110, the foot end translation assembly 135, and the foot end pitch/rollassembly 140. The foot end vertical support 100 of the base 15 extendsvertically upward from the wheeled base 105 and is generally centeredright-to-left on the wheeled base 105 and centered right-to-leftrelative to the base frame member 142. The foot end translation assembly135 and the foot end pitch/roll assembly 140 are found near the top ofthe foot end vertical support 100.

1. The Foot End Vertical Support

FIG. 24 is a left side isometric view of a rear region of the verticalsupport 100 of the foot end 70 of the base 15. As can be understood fromFIGS. 22-24, the vertical support 100 of the foot end 70 issubstantially similar to the vertical support 100 of the head end 60discussed above with respect to FIGS. 7 and 11-13.

As can be understood from FIGS. 22-24, in one embodiment, the foot endvertical support 100 includes a telescopic arrangement of an outersegment 150, an intermediate segment 152 within the outer segment 150,and an inner segment 154 within the intermediate segment 152. The bottomend of the outer segment 150 is fixedly connected to the wheel base 105,the intermediate segment 152 is vertically displaceable along the outersegment 150, and the inner segment 154 is vertically displaceable alongthe intermediate segment 152. A top end of the inner segment 154 isfixedly connected to a base plate 156 of the foot end translationassembly 135, and the foot end translation assembly 135 is fixedlyconnected to a top plate 158 of a mount 160 supporting the foot endpitch/roll assembly 140. In other words, the foot end translationassembly 135 is sandwiched between the top end of the foot end verticalsupport 100 and the mount 160 supporting the foot end pitch/rollassembly 140 thereby facilitating the front/rear displacement of thefoot end pitch/roll assembly 140 along the longitudinal axis of the base15 relative to the foot end vertical support 100, as described ingreater detail below. Also, since the top end of the inner segment 154is coupled to the foot end pitch/roll assembly 140 via the sandwichedarrangement of the top plate 158, foot end translation assembly 135 andmount 160, the foot end pitch/roll assembly 140 is verticallydisplaceable via the foot end vertical support 100 relative to the footend wheeled base 105.

The vertical displacement of the intermediate segment 152 and the innersegment 154 may be brought about by a variety of mechanical arrangementsacting on the segments including, but not limited to, screw drivenlinear actuators, rack and pinion arrangements, hydraulic or pneumaticrams, etc. While the segments 150, 152, 154 are depicted as beingtelescopically arranged, the segments may have other configurations solong as the segments facilitate the foot end vertical support 100vertically adjusting so as to be adjustable in its overall height. Inone embodiment, the foot end vertical support 100 may be heightadjustable up to approximately 37 inches in total adjustment. In oneembodiment, the height adjustment may be infinitely adjustable such thatthe adjustments are not incremental. In other embodiments, the heightadjustment may be incrementally adjustable such that the heightadjustments are divided over a set number of increments. In someembodiments, the height adjustment may be selectively available aseither infinitely adjustable or incrementally adjustable as a functionof software operation and selections made by an operator of the table atthe computer interface screen 145.

2. The Foot End Translation Assembly

FIG. 25 is the same view as FIG. 24, except with the top plate 158 ofthe mount 160 supporting the foot end pitch/roll assembly 140 removed tomore clearly depict components of the foot end translation assembly 135.As can be understood from FIGS. 24-25, the foot end translation assembly135 is similar to that of the head end translation assembly 125discussed above with respect to FIGS. 13-14, except the embodiment ofthe foot end translation assembly shown in FIGS. 24-25 may be passive inthat it is not directly actuated by a linear actuator but instead relieson forces transmitted through the patient platform 20 from the linearactuator 168 of the head end translation assembly 125 or by thedisplacement of the patient platform 20 itself to bring aboutdisplacement in the foot end translation assembly 135. In otherembodiments, the foot end translation assembly 135 may be generallyidentical to that of the head end translation assembly 125 such that thefoot end translation assembly 125 is actively displaced via its ownlinear translator.

As indicated in FIGS. 24-25, the passive version of the foot endtranslation assembly 135 includes the base plate 156, rails 164, andslotted blocks 166. The rails 164 are fixedly connected to the baseplate 156, which is fixedly connected to the top end of the innersegment 154 of the foot end vertical support 100. The slotted blocks 166are each coupled to a respective rail 164 in a sliding arrangement suchthat each slotted block 166 slides along its respective rail 164. Theslotted blocks are also fixedly connected to the bottom surface of thetop plate 158 of the mount 160 supporting the foot end pitch/rollassembly 140. Thus, the sliding block/rail arrangement of the foot endtranslation assembly 135 is sandwiched between the base plate 156 (whichis fixedly connected to the top end of the foot end vertical support100) and the top plate 158 of the mount 160 supporting the foot endpitch/roll assembly 140 thereby facilitating the front/rear displacementof the foot end pitch/roll assembly 140 along the longitudinal axis ofthe base 15 relative to the foot end vertical support 100.

As stated above, the translation assemblies 125, 135 work together tocompensate for the change in effective distance between the pitch/rollassemblies 130, 140 brought about by the rigid exterior frame 300 of thepatient support 20 changing slope from a horizontal orientation betweenthe opposed vertical supports 100 and a sloped orientation between theopposed vertical supports 100 and vice versa. Because the translationassemblies 125, 135 compensate for such movement of the rigid exteriorframe 300, the opposed columns 100 can remain a fixed distance from eachother while the exterior rigid frame transitions between horizontal andvarying degree of slope, and vice versa.

In other words, because the length of the rigid exterior frame 300 ofthe patient support 20 is fixed, when the exterior rigid frame ishorizontal as shown in FIG. 3, the pitch/roll assemblies 130, 140 willbe at their further distance apart, the slotted blocks 166 of therespective translation assemblies 125, 135 having displaced theirgreatest extent apart along their rails 164. Thus, the top plates 158 ofthe mounts 160 supporting the respective pitch/roll assemblies 130, 140will move away from each other (i.e., diverge) as indicated by arrows Ain FIGS. 13 and 24.

As the rigid exterior frame 300 of the patient support 20 transitions toan increasingly sloped orientation (e.g., as depicted in FIG. FIGS.44-46), the distance between the pitch/roll assemblies 130, 140 willhave to decrease as the sloped length of the exterior rigid frame is ahypotenuse of a triangle and the horizontal distance between thepitch/roll assemblies is a base of the triangle and, as a result, lessthan the hypotenuse. Thus, when the rigid exterior frame 300 of thepatient support 20 is at its maximum slope, the pitch/roll assemblies130, 140 will be at their smallest distance apart, the slotted blocks166 of the respective translation assemblies 125, 135 having displacedtowards each other to the greatest extent along their rails 164. Thus,the top plates 158 of the mounts 160 supporting the respectivepitch/roll assemblies 130, 140 will move towards each other (i.e.,converge) as indicated by arrows B in FIGS. 13 and 24.

The foot end translation assembly 135 is also present and configured tofacilitate the surgical field being held stable during the variousmanipulations of the surgical field by the patient support 20 beingdisplaced relative to the base 15 and/or the patient 12 being flexed,extended or placed neutral by the deflection of the patient supportinner frame 302 relative to the patient support outer frame 300, asdiscussed below. The head end and foot end translation assemblies 125,135 are coordinated in this function by software driving the servomotorsof the translation assemblies 125, 135.

3. The Foot End Pitch/Roll Assembly

To begin a detailed discussion of the foot end pitch/roll assembly 140of the base 15 of FIG. 1, reference is made to FIGS. 22-24 and 26-27.The foot end pitch/roll assembly 140 may also be called a secondconnection assembly. FIG. 26 is a horizontal cross section focused onthe pitch assembly 172 as taken along section line 26-26 in FIG. 24.FIG. 27 is a cross sectional isometric elevation focused on the rollassembly 174 as taken along section line 27-27 in FIG. 23.

As can be understood from FIGS. 22-24 and 26-27, the foot end pitch/rollassembly 140 is similar to that of the head end pitch/roll assembly 130discussed above with respect to FIGS. 10 and 15-21, except theembodiment of the roll assembly 174 of the foot end pitch/roll assembly140 shown in FIGS. 22-24 and 26-27 may be passive in that it is notdirectly actuated by a motor driven worm drive but instead relies onforces transmitted through the patient platform 20 from the motor drivenworm drive 190 of the roll assembly 174 of the head end pitch/rollassembly 130 to bring about displacement in the roll assembly 174 of thefoot end pitch/roll assembly 140. In other embodiments, the rollassembly 174 of the foot end pitch/roll assembly 140 may be generallyidentical to that of the roll assembly 174 of the head end pitch/rollassembly 130 such that the roll assembly 174 of the foot end pitch/rollassembly 140 is actively displaced via its own motor driven worm driveor other active drive mechanism.

As can be understood from FIGS. 22-24 and 26-27, the foot end pitch/rollassembly 140 includes a pitch assembly 172 pivotally connected to themount 160 and a roll assembly 174 pivotally coupled to an arm or yoke176 of the pitch assembly 172. The pitch assembly 172 includes the pitcharm 176 and a linear drive 178 having a motor 180. Forward or fulcrumpins 182 extend from the right and left sides of the mount 160 to bepivotally received by pivot holes 185 in the right and left sides of thepitch arm 176 to combine together as fulcrums or pivots about which thepitch arm 176 pivots relative to the mount 160, as indicated by arrows Gin FIGS. 22 and 23.

As seen in FIGS. 3, 38A-38B, 46, 49, and 52, among others, the pitchassemblies 172 on the head end and foot ends function to maintain asubstantially parallel alignment of the H-frames 206 and the ladderattachment assemblies 198 with each other during pitching or angling ofthe patient support 20 about an axis transverse to a longitudinal axisof the patient support 20. Additionally, the pitch assemblies 172 areconfigured to actively maintain the roll assemblies 174 in a coaxialalignment with each other during angling or pitching of the patientsupport 20 (more particularly, the outer frame 300) relative to thevertical supports 100. Thus, during pitching or angling of the outerframe 300 of the patient support 20 relative to the vertical supports100, the axels 196 of the roll assemblies 174 are coaxial aligned suchthat the roll axis extends through the axels 196 of the roll assemblies174. The roll assemblies 174 and, thus, the roll axes A, B as shown inFIG. 7, remain coaxially aligned because the pitch assemblies 172 or,more particularly, the linear drives 178 act between their respectiveanchor pins 188 and lever arm pins 186 to cause the roll assemblies 174to angle or pitch upward or downward in response to the actuation of thelinear drives 178.

This type of powered pitching or angling of the roll assemblies 174 atthe support columns 100 such that the roll axes A, B remain coaxiallyaligned substantially reduces or eliminates binding of the variousconnections between the patient support 20 and the support columns 100.Without maintaining coaxial alignment of the roll axes, a full roll(i.e., 360 degrees) may not be possible. Conventional tables may alignthe roll axes when the patient support 20 is in a neutral position(i.e., parallel to the floor). But, often a patient must be in anon-neutral position (e.g., Trendelenburg, reverse Trendelenburg) andpartially rolled. Thus, there is a need for a surgical table that canroll the patient support in non-neutral positions while activelymaintaining the roll axes in coaxial alignment.

The coaxial alignment of the roll assemblies 174 is maintained by thepitch assemblies 172 when, for example, the head end 55 of the patientsupport 20 is at a different vertical elevation than the foot end 65 ofthe patient support 65, via the vertical supports 100 of the head andfoot end being extended different vertical heights. In this exampleorientation of the patient support 20, among others, the pitchassemblies 172 are actuated to position the ladder attachment assemblies198 generally parallel to each other and the roll assemblies 174 in-linesuch that a longitudinal axis of the axels 196 are coaxial.

Rearward or lever arm pins 186 extend from the right and left sides ofthe pitch arm 176 rearward of the fulcrum pins 182 to be pivotallyreceived by the upper ends of the linear drives 178, thereby forminglever points to act about the fulcrums. Bottom ends of the linear drives178 are pinned via anchor pins 188 to a bottom region of each respectiveside of the mount 160, thereby forming anchor points.

Thus, when the linear drives 178 act between their respective anchorpins 188 and lever arm pins 186 such that the linear drive 178 extends,the pitch arm 176 is caused to pitch downward about the fulcrum pins182, thereby driving the roll assembly 174 to pitch downward asindicated by arrow H in FIG. 22. Similarly, when the linear drives 178act between their respective anchor pins 188 and lever arm pins 186 suchthat the linear drive 178 retracts, the pitch arm 176 is caused to pitchupward about the fulcrum pins 182, thereby driving the roll assembly 174to pitch upwardly as indicated by arrow J in FIG. 22.

As can be understood from FIGS. 22-24 and 26-27, the roll assembly 174includes an axel 196 that extends rearward from a center of a ladderattachment assembly 198. The ladder attachment assembly 198 includesupper and lower horizontal slots 200, each such slot including a pair ofspaced-apart hooked attachment mechanisms 202 that retain a horizontalbar 204 of an H-frame 206 received in the respective slot 200, as wasdiscussed above with respect to FIG. 10. The H-frame 206 of the foot end70 is identically configured and used with the foot end ladderattachment assembly 198 as discussed above in the discussion of the headend pitch/roll assembly in Subsection I(b)(3) of this DetailedDescription of the Preferred Embodiments.

As can be understood from FIGS. 22-24 and 26-27, the axel 196 extendsrearward from a center of the ladder attachment assembly 198 such that arearward half of the axel 196 is pivotally supported by front and rearbearing rings 212 in a cylindrical opening 214 of a front portion 216 ofthe pitch arm 176. Thus, the axel 196 is pivotally supported in, andrelative to, the front portion 216 of the pitch arm 176. The ladderattachment assembly 198 is fixed to the front end of the axel 196 and,as a result, is pivotal relative to the front portion 216 of the pitcharm 176.

As already mentioned, actuation of the worm drive 190 of the rollassembly 174 of the head end pitch/roll assembly 130 causes the patientplatform 20 to roll or displace about the axes A, B shown in FIG. 7,thereby causing the axel 196 of the roll assembly 174 of the foot endpitch/roll assembly 140 to pivot relative to the front portion 216 ofthe pitch arm 176 of the foot end pitch/roll assembly 140. The resultingfirst and second roll directions can be understood from arrow K in FIG.22.

As shown in FIGS. 22-24 and 26-27, a window 218 is defined in the upperfront region of the mount 160 to facilitate pitch clearance for thefront portion 216 of the pitch arm 176 as the pitch arm is cause topitch up and down.

While the above-described base 15 is advantageous when used with thebelow-described patient platform 20, it should be noted that embodimentsof the above-described base could be employed with other patientplatforms of the applicants' development with little or no modificationsto either the base or the patient platforms. Similarly, while thebelow-described patient platform 20 is advantageous when used with theabove-described base 15, it should be noted that embodiments of thebelow-described patient platform could be employed with other bases ofthe applicants' development with little or no modifications to eitherthe patient platform or bases. Accordingly, the disclosures ofApplicants' prior US provisional and nonprovisional applications areincorporated into this present disclosure in their entireties.

II. The Patient Platform

To begin the detailed discussion of the patient support 20, reference ismade to FIGS. 1-4 where it can be understood that the patient support 20is supported above the floor surface 25 by the base 15. Morespecifically, as can be understood from FIGS. 1-4, 10 and 17, the headend 55 of the patient support 20 is pivotally coupled to a bottomhorizontal bar 204 of the H-frame 206 extending from the ladderattachment assembly 198 of the head end 60 of the base 15. Similarly,the foot end 65 of the patient support 20 is pivotally coupled to abottom horizontal bar 204 of the H-frame 206 extending from the ladderattachment assembly 198 of the foot end 70 of the base 15. The patientsupport 20 includes an outer frame 300 and an inner frame 302, which inaddition to being capable of articulating relative to itself, issupported off of and displaceable relative to the outer frame 300.

FIGS. 28 and 29 are, respectively an isometric view and an explodedisometric view from a left side and head end perspective of the patientsupport 20, wherein the inner frame 302 is in a neutral positionrelative to the outer frame 300. FIG. 30 is also an exploded isometricview of the patient support 20, except from a right side and foot endperspective of the patient support 20. As can be understood from FIGS.28-30 and described in greater detail below, the patient support 20includes the outer frame 300, the inner frame 302, right and left innerframe drive assemblies 304, and a torso support assembly 306. Theextreme opposed ends 55, 65 of the outer frame 300 are the respectivehead end 55 and foot end 65 of the patient support 20 discussed abovewith respect to FIGS. 1-4.

As shown in FIGS. 28-30, the torso support 306 is supported on a headend region of the outer frame 300. The torso support includes a chestpad 280 and right and left arm supports 282.

As indicated in FIGS. 1-4, the torso support 306 is configured tosupport the torso and arms of the patient 12 when in a prone position onthe patient support 20. The torso support 306 does not displace alongthe outer frame 300 as a function of the inner frame 302 displacingrelative to the outer frame 300. However, the torso support 306 isadjustable along the outer frame 300 to provide for proper placement ofthe chest pad 280 and arm pads 282 as need to accommodate the size ofthe patient 12.

As can be understood from FIGS. 28-30, the outer frame 300 defines astructure on which the inner frame 302, the drive assemblies 304 and thetorso support assembly 306 are mounted. The outer frame 300 is rigid inthat it does not change with respect to configuration or arrangement. Inother words, the outer frame 300 does not have a joint along its lengthor width that allows the outer frame 300 to articulate relative toitself along its length, width or height.

In contrast to the outer frame 300, and as will be discussed in greaterdetail below, the inner frame 302 is not rigid, but has right and leftarticulation joints 308 along its length that allows the inner frame 302to articulate relative to itself along its length and about the joint308. Further, the inner frame 302 is moveably coupled to the outer frameat right and left slider joints 310 to be both pivotally displaceablerelative to the outer frame 300 and slidably displaceable relative tothe outer frame 300.

The drive assemblies 304 act between the outer frame 300 and thearticulation joints 308 to bring about the articulation of the innerframe 302 at the articulation joints 308 and the accompanying pivotingand sliding of the inner frame 302 relative to the outer frame 300 atthe slider joints 310. As discussed in detail below, each drive assembly304 includes a linear drive assembly 312, a rotation drive assembly 314,and a link arm 316 that transfers forces from the respective driveassembly 304 to the respective articulation joint 308 of the inner frame302 to bring about displacement of the inner frame 302 relative to theouter frame 300 and to also bring about articulation of the inner frame302 about itself at the articulation joints 308.

The outer frame 300 is rolled and pivoted via the head end pivot/rollassembly 130 and the foot end pivot/roll assembly 140 between which theouter frame 300 extends as a rigid frame work that does not changestructural configuration and also does not articulate relative to orabout itself. The inner frame 302 is coupled to the outer frame 300 toboth pivot and slide relative to the outer frame 300 that serves as theunchanging base on which the inner frame 300 also articulates relativeto and about itself. The drive assembly 314 brings about both thearticulation of the inner frame 302 and the pivoting and slidingdisplacement of the inner frame 302 relative to the outer frame 300.

a. The Rigid Outer Frame

As indicated in FIGS. 28-30, the outer frame 300 of the patient platform20 includes the head end 55, the foot end 65 opposite the head end 55,and right and left side structures 330 that extend between end members332 at the head and foot ends 55, 65. The end members 332 join togetherthe side structures 330 to form the generally rectangular outer frame300.

Each side structure 330 includes a lower or depressed center region 334approximately midway between a head end region 336 and a foot end region338 that are higher than the depressed center region 334. To provideright-to-left clearance for the inner frame 302, the foot end region 338is wider right-to-left than the head end region 334, and the transitionin width occurs caudad of the head end region 336 and, in someinstances, along at least a portion of the center region 334. Eachdepressed center region 334 includes a multi-tiered surface including asloped surface 340 and a horizontal surface 342. The sloped surface 340extends from the foot region 338 towards the head end 55, and thehorizontal surface 342 extends from the sloped surface 340 towards thehead end 55.

A slightly sloped transition region 344 between the head end region 336and the depressed center region 334 transitions between these tworegions and includes a slightly inclined slider slot 346 definedtherein. Such slider slots 346 are part of a pivoting and slidingcoupling between the outer frame 300 and the inner frame 302, asdiscussed below.

Each depressed center region 334 also includes a drive assembly supportstructure 350 that supports a drive assembly 304. The drive assemblysupport structure 350 includes a horizontal slot 352 along which therotation drive assembly 314 and an end of the link arm 316 displaces.

b. The Displaceable and Articulating Inner Frame

FIG. 31 is an exploded isometric view of the drive assemblies 314, innerframe 302 and the depressed regions 334 of the side structures 330 ofthe outer frame 300 as viewed from a right side and head endperspective, wherein the inner frame 302 is in a neutral positionrelative to the outer frame 300. As shown in FIG. 31, the inner frame302 includes a head end or upper leg member or region 360 and a foot endor lower leg member or region 362. The head end region 360 includesright and left first members 364, each such member including a sliderend 366 and an articulation joint end 368. A hip pad 369 is located oneach first member 364 adjacent the slider end 366. A slider pin 367couples each slider end 366 to its respective slider slot 346 defined inthe side structures 330 of the outer frame 300 resulting in a slidingand pivoting coupling relationship with the respective slider slot 346to form the respective slider joint 310.

The foot end region 362 includes right and left second members 370, eachsuch member including an articulation joint end 372 and a free end 374.Contact members 376 extend horizontally and perpendicularly from thefree ends 374 in a pivotal coupling arrangement. A cross member 380extends between the pair of second members 370 near the free ends 374.

The articulation joint ends 368, 372 are pivotally coupled to each othervia an articulation joint pin 378 to form the articulation joints 308 ofthe inner frame 302, and as will be discussed below, the link arms 316are also pinned to the articulation joints 308 via the pins 378. Thus,actuation of the drive assemblies 304 cause the link arms 316 to actagainst the articulation joints 308, bringing about displacement of theinner frame 302 relative to the outer frame 300 and also causing thefoot end region 362 of the inner frame 302 to articulate relative to thehead end region 360 of the inner frame 302 about the articulation joints308.

As can be understood from FIGS. 42A-43C, the mechanical arrangement ofthe articulation joint 308 formed by the articulation joint ends 368,372 is such that the free end 374 can pivot upwardly relative to thearticulation joint 308, as is the case when the inner frame 302 assumesthe lower position indicated in FIGS. 42C and 43C. However, on accountof an interlocking mechanical arrangement between the articulation jointends 368, 372 of the first and second members 364, 370 at thearticulation joint 308, the free end 374 is prevented from rotatingdownward relative to the articulation joint 308 to any degree lower thanthe articulation joint 308. Thus, as indicated in FIGS. 42A-42B and43A-43B, the result is the first and second members 364, 370 form astraight line when the free end 374 reaches its greatest downward extentrelative to the articulation joint 308, as is the case when the innerframe is in the elevated position (see FIGS. 42A and 43A) or when theinner frame is in the neutral position (see FIGS. 42B and 43B).

c. The Inner Frame Drive Assemblies

As can be understood from FIGS. 28, 30 and 31, the drive assemblies 304act between the outer frame 300 and the articulation joints 308 to bringabout the articulation of the inner frame 302 at the articulation joints308 and the accompanying pivoting and sliding of the inner frame 302relative to the outer frame 300 at the slider joints 310. Each driveassembly 304 includes a linear drive assembly 312, a rotation driveassembly 314, and a link arm 316 including a lower end 318 and an upperend 320.

As can be understood from FIGS. 28-31, each link arm upper end 320 iscoupled via the articulation joint pin 378 to a respective articulationjoint 308 of the inner frame 302, and each link arm lower end 318 iscoupled to, and pivotally driven by, a respective rotation driveassembly 314. Each rotation drive assembly 314 acts between a respectivelinear drive assembly 312 and respective link arm 316 to cause the linkarm 316 to pivot in a plane extending lengthwise along the length of therigid frame 300 and perpendicular to a right-to-left width of the rigidframe, thereby bringing about displacement and articulation of therespective articulation joint 308 and sliding at the respective sliderjoint 310.

Each linear drive assembly 312 acts between the outer frame 302 and arespective rotation drive assembly 314 to linearly displace the rotationdrive assembly 314 relative to the outer frame 300, thereby adding tothe articulation of the respective articulation joint 308 and sliding atthe respective slider joint 310.

Electrical power to the inner frame drive assemblies can be routedthrough one or both ladder attachment assemblies 198, as seen in FIG.22, or even one or both of the shafts 196, through the outer frame 300and to the motors of the respective drives of the inner frame driveassemblies.

1. The Linear Drive Assemblies

FIG. 32 is an enlarged view of the exploded linear drive assembly 312illustrated in FIG. 30. As shown in FIG. 32, the linear drive assembly312 includes a linear guide rail 400, a slider block 402, a lead screw404, a lead screw nut 406 with its mount 408, various bearing rings 410,and a drive motor 412 with its gear box 414. A bearing block 420 mayalso be considered part of the linear drive assembly 312, and isdepicted in FIG. 31.

FIG. 33A is the same view as FIG. 31, except in an assembled state.FIGS. 33B-33C is the same view as FIG. 33A, except illustrating theinner frame 302 in a neutral and lowered positions relative to the outerframe, respectively. FIGS. 34A-34C illustrate same respective conditionsand essentially the same components as FIGS. 33A-33C, except from alower perspective. As shown in FIGS. 33A-34C, slider block 402 ismounted on the linear guide rail 400 in sliding engagement such that theslider block 402 can slide along the rail 400 back and forth in thedirections of the head end and foot end of the patient platform 20. Asindicated in FIGS. 33A-33C, the linear guide rail 400 is fixedly coupledto the drive assembly support structure 350 of the depressed centerregion 334 of the outer frame 300.

As depicted in FIGS. 33A-34C, the lead screw mount 408 couples the leadscrew nut 406 to the slider block 402. The drive motor 412 is fixedlysupported off of the drive assembly support structure 350 and, via itsgear box 414, is configured to cause the lead screw 404 to rotate aboutits longitudinal axis. The lead screw 404 is pivotally supported off ofthe drive assembly support structure 350 in a parallel arrangement withthe linear guide rail 400 and extends through the lead screw nut 406 ina threaded engagement. Thus, rotation of the lead screw 404 causes thecoupled together lead screw nut 406 and its mount 408 to displace alongthe lead screw 404, thereby driving the slider block 402 along thelinear guide rail 400. As the bearing block 420 couples the slider block402 to the lower end 318 of the link arm 316, the linear displacement ofthe slider block 402 causes the lower end 318 of the link arm 316 tohave the same linear displacement. Such linear displacement providessome articulation of the respective articulation joint 308 and slidingat the respective slider joint 310.

2. The Rotation Drive Assemblies

FIG. 35 is an enlarged view of the exploded rotation drive assembly 314illustrated in FIG. 29. As shown in FIG. 29, the rotation drive assembly314 includes a drive shaft 500, various bearing rings 510, and a drivemotor 512 with its gear box 514. As can be understood from FIGS.33A-34C, the bearing block 420 couples the drive motor 512 and its gearbox 514 to the slider block 402 such that the rotation drive assembly314 linearly displaces with slider bock 402 when the slider block 402 iscaused to linearly displace along the linear guide rail 400 of thelinear drive assembly 312.

The drive shaft 500 pivotally extends thorough the bearing block 420 tofixedly connect with the lower end 318 of the link arm 316. Thus, whenthe drive motor 512 via its gear box 514 causes the drive shaft 500 torotate about is longitudinal axis relative to the bearing block 420, thelink arm 316 is caused to pivot about the longitudinal axis of the driveshaft 500 in a plane extending lengthwise along the length of the rigidframe 300 and perpendicular to a right-to-left width of the rigid frame,thereby bringing about displacement and articulation of the respectivearticulation joint 308 and sliding at the respective slider joint 310.

The linear drive assembly 312 acts between the outer frame 302 and itsrespective rotation drive assembly 314 to linearly displace the rotationdrive assembly 314 relative to the outer frame 300. This lineardisplacement of the rotation drive assembly 314 and the lower end 318 ofthe link arm 316 adds to the articulation of the respective articulationjoint 308 and sliding at the respective slider joint 310 provided by therespective rotation drive assembly 314.

d. The Displacement of the Inner Frame Assembly

For a discussion of the movement of the components of the drive assembly304 and the inner frame 302 relative to the outer frame 300, referenceis first made to FIGS. 39A, 40A, 41A, 42A and 43A where the inner frame302 is shown in the elevated position. In the following discussion, theterm caudad is used to indicate that something is moving, facing,located or oriented in the direction of the foot end 65 of the patientplatform 20. Similarly, the term cephalad is used to indicate thatsomething is moving, facing or oriented in the direction of the head end55 of the patient platform 20.

As indicated in FIGS. 39A, 40A, 41A, 42A and 43A, among others, thefirst and second members 364, 370 form a straight line when the freeends 374 reach their respective greatest downward extent relative to therespective articulation joints 308. The slider block 402, bearing block420 and rotation drive 314 are located approximately at the midpoint ofthe length of the linear guide rail 400 and the screw drive shaft 404.The lower end of the link arm and the drive axel 500 of the rotationassembly 314 are likewise at the midpoint of the length of the slot 352in the drive assembly support structure in the recessed region of theouter frame 300. The link arm 316 extends at approximately a 30 degree(plus or minus approximately 15 degrees) angle from vertical from thedrive axel 500 of the rotation assembly 314. The slider pin 367 is atthe lowest and most caudad end of the slider slot 346 of the sliderjoint 310. The slider slot 346 can be seen to have an incline relativeto horizontal of approximately 30 degrees, plus or minus approximately15 degrees.

FIGS. 39B, 40B, 41B, 42B and 43B illustrate the inner frame 302 in theneutral position. As indicated in these figures, the first and secondmembers 364, 370 form a straight line when the free ends 374 reach theirrespective greatest downward extent relative to the respectivearticulation joints 308. Also, the contact members 376 at the free ends374 rest on the flat upper surface of the foot end region of the outerframe 300 (see FIGS. 39B, 40B and 41B). The slider block 402, bearingblock 420 and rotation drive 314 are located approximately at the mostcaudad end of the linear guide rail 400 and the screw drive shaft 404.The lower end of the link arm and the drive axel 500 of the rotationassembly 314 are likewise at the most caudad end of the length of theslot 352 in the drive assembly support structure in the recessed regionof the outer frame 300. The link arm 316 extends at approximately a 60degree (plus or minus approximately 15 degrees) angle from vertical fromthe drive axel 500 of the rotation assembly 314. The slider pin 367 isat slightly caudad of the midpoint of the slider slot 346 of the sliderjoint 310.

FIGS. 39C, 40C, 41C, 42C and 43C illustrate the inner frame 302 in thelower position. As indicated in these figures, the first and secondmembers 364, 370 form approximately a 90 degree angle (plus or minus 15degrees) at the articulation joints 308. Also, the contact members 376at the free ends 374 rest on the transition between the sloped surface340 and the flat surface 342 of the recessed region of the outer frame300 (see FIGS. 39C, 40C and 41C). The slider block 402, bearing block420 and rotation drive 314 are located approximately at the mostcephalad end of the linear guide rail 400 and the screw drive shaft 404.The lower end of the link arm and the drive axel 500 of the rotationassembly 314 are likewise at the most cephalad end of the length of theslot 352 in the drive assembly support structure in the recessed regionof the outer frame 300. The link arm 316 extends at approximately a 30degree (plus or minus approximately 15 degrees) angle downward fromhorizontal from the drive axel 500 of the rotation assembly 314. Theslider pin 367 is at the highest and most cephalad end of the sliderslot 346 of the slider joint 310.

As can be understood from FIGS. 39A-43C, when drive assembly 304 causesthe inner frame 302 to transition from of the elevated position depictedin FIGS. 39A, 40A, 41A, 42A and 43A to the neutral position of the FIGS.39B, 40B, 41B, 42B and 43B, the drive axels 500 and the link arm lowerends 318 displace linearly caudad from approximately the midpoints ofthe screw drives 404 to approximately the most caudad points of thescrew drives 404. At the same time, the drive axels 500 causes the linkarm upper ends 320 to arc cephalad and downward from approximately 30degrees cephalad of vertical until the link arms 316 are approximately60 degrees cephalad of vertical. While all of this is occurring, theupper and lower segments 364, 370 of the inner frame 302 remain straightextending across the articulation joints 308, the contact members 376 atthe free ends 374 go from being elevated above the outer frame 300 tocoming into contact with the caudad region of the outer frame, and theslider pins 367 move cephaladly approximately one third of the totallength of the slider slots 346 from the most caudad and lowest ends ofthe slider slots 346.

As can be understood from FIGS. 39A-43C, when drive assembly 304 causesthe inner frame 302 to transition from of the neutral position depictedin FIGS. 39B, 40B, 41B, 42B and 43B to the lower position of the FIGS.39C, 40C, 41C, 42C and 43C, the drive axels 500 and the link arm lowerends 318 displace linearly cephalad from approximately the most caudadpoints of the screw drives 404 to approximately the most cephalad pointsof the screw drives 404. At the same time, the drive axels 500 causesthe link arm upper ends 320 to arc cephalad and downward fromapproximately 60 degrees cephalad of vertical until the link arms 316are approximately 30 degrees below horizontal. While all of this isoccurring, the upper and lower segments 364, 370 of the inner frame 302transition from being straight extending across the articulation joints308 to forming approximately a 90 degree angle at the articulationjoints 308, the contact members 376 at the free ends 374 go fromcontacting the caudad region to rolling or sliding along the outer frame300 and traveling down the inclined portions 340 of the recessed regionof the outer frame to eventually come to rest at the transitions betweenthe inclined portions 340 and the horizontal portions 342 of therecessed region of the outer frame 20. This contact between the contactmembers 376 and the components of the outer frame 300 facilitatedeflecting the lower leg region 362 relative to the upper leg region 360about the joint 308. At the same time, the slider pins 367 movecephaladly to the most cephalad and highest ends of the slider slots 346from the spots that were approximately one third of the total lengths ofthe slider slots 346 from the most caudad and lowest ends of the sliderslots 346.

To transition from the lowest position, through the neutral position, tothe elevated position, the above-described directions and order ofmovements can simply be reversed.

These above-described transition processes can be automated by softwarestored on the computer, the software including instructions to therotation and linear drive assembly motors that mimic the above-describeddirections and order of movements. Limit switches and various sensorscan be provided in the components of the drive assembly and/or on theinner frame that indicate to the computer when any of the threeabove-described inner frame positions have been achieved, signaling theuser of such a state and stopping the drive assembly from trying tofurther displace the inner frame until signaled by the user via thecomputer to transition to another inner frame position.

e. The Patient Interaction with the Inner Frame Assembly

For a discussion of the movement of the patient relative to the innerframe when the inner frame is displacing, reference is made to FIGS. 1-4and FIGS. 36A-38B. As can be understood from these figures, butespecially from FIGS. 3 and 38A-38B, when the upper leg support region360 and lower leg support region 362 work together to flex the patientfrom neutral, the hip pads 369 angulate or rotate downward and,additionally, slide cephalad. When the upper leg support region 360 andlower leg support region 362 work together to extend the patient fromneutral, the hip pads 369 angulate or rotate upward and, additionally,slide caudad. As can be understood from the figures discussed herein,the displacement of the hip pads 369, and the patient 12 resting thereinon, is such that the spine of the patient 12 is not compressed ordistracted as the patient is transitioned between extension, neutral, orflexion, vice versa or in any other order or sequence.

f. Positioning of the Patient Support Relative to the Base

As noted above, the outer frame 300 of the patient platform 20 is rolledand pitched via the head end pivot/roll assembly 130 and the foot endpivot/roll assembly 140 of the surgical table base 15. The outer frame300 extends as a rigid frame work that does not change structuralconfiguration and also does not articulate relative to or about itself,while the inner frame 302 displaces relative to the outer frame 300 andalso articulates relative to itself.

Articulations of the patient are brought about by the displacement ofthe inner frame 302 relative to the outer frame 300. However, pitchingand rolling of the patient are brought about by pitching or rolling theentire patient platform 20 relative to the based 15. Via the operationof the inner frame relative to the outer frame and the entire patientplatform relative to the frame, the patient may be place in a variety ofpositions while the roll axes of the respective roll assemblies remaincoaxial, as discussed above with respect to FIG. 7. Examples of patientpositions includes, but are not limited to, prone positioning, supinepositioning, lateral decubitis positioning, seated positioning, etc.

With respect to prone positioning, the patient may be placed in neutral,flexion and extension positions. The patient support can have its chestand hip pads moved and or removed as needed for the procedure.

Supine positioning involves providing separate flat-top surfaces on thethigh regions of the inner frame 302 and on the head end region of theouter frame 300, these separate flat-top surfaces being positionedrelative to the articulation joint 308 so as to articulate relative toeach other. Additional pads or pillows can be positioned on the flat-topsurfaces, as needed.

Lateral decubitis positioning flexes the patient with the thigh regionof the inner frame 302 dependent in a declining orientation, wherein thefoot end of the inner frame is close to the floor.

FIGS. 44-52 illustrate some of these sample positions of the patientplatform of the surgical table. Positioning capabilities of the surgicaltable 10 disclosed herein should not be considered as being limited tothose positions illustrated in the accompanying figures or as describedherein, but are provided merely as examples. Those of skill in the artwill readily understand from the drawings and description the wide rangeof positioning options provided via the surgical table.

Reference will initially be made to FIGS. 44-46, which are respectiveisometric head end, isometric foot end, and side views of an embodimentof the surgical table 10 with the patient support 20 positioned withflat-top pads 600 and a pad 602 to position a patient (not shown) in aseated and slightly reclined position. As seen in the figures, thepatient support 20 is elevated at the head end 55 relative to the footend 65 and the inner frame 302 is articulated at the articulation joint368 such that the joint 368 is at an apex or high point relative to theupper and lower leg members 360, 362. In this orientation, the head endvertical support 100 is extended such that the intermediate segment 152and the inner segment 154 are extended out from the outer segment 150.Opposite the head end vertical support 100, the foot end verticalsupport 100, coupled with the foot end 65 of the patient support, is inan un-extended position. The foot end vertical support 100 may, however,be somewhat extended in this position, as long as it is extendedvertically less than the head end vertical support 100.

As seen and as discussed in reference to FIGS. 31, 33A, 36A, 37A, 38A,39A, 40A, 41A, 42A, and 43A, among others, when the patient support 20is in an extended position, the upper leg member 360 and the lower legmember 362 of the inner frame 302 are generally parallel to each otherand angled upward relative to the outer frame 300. The upper and lowerleg members 360, 362 remain parallel in this orientation, as opposed toflexing at the joint 368, is because the articulating joint 368 isconfigured so as to prohibit rotation of the upper and lower leg members360, 362 past the point of being parallel or one hundred eighty degreesrelative to each other. There may, for example, be a pull-pin (notshown) at the location of the articulating joint 368 that prevents thelower leg member 362 from rotating past one hundred eighty degreesrelative to the upper leg member 360. The pull-pin may, however, allowrotation of the upper and lower leg members 360, 362 to rotate intoflexion, as seen and described in reference to FIGS. 34C, 36B, 37B, 38B,39C, 40C, 41C, 42C, and 43C, among others. That is, rotation (i.e.,passive or active) of the upper and lower leg members 360, 362 of lessthan one hundred eighty degrees is unrestricted. The pull-pin mayfunction to lock or otherwise not allow rotation past one hundred eightydegrees.

Referring back to FIGS. 44-46, to facilitate the inner frame 302 of thepatient support 20 flexing at the articulating joint 368 such that thejoint 368 is at an apex (i.e., the upper and lower leg members 360, 362rotation past or beyond one hundred eighty degrees relative to eachother), the pull-pin may be removed or disengaged with the articulatingjoint 368 such that the joint 368 is able to freely rotate into theseated position. The pull-pin may be re-engaged or reinserted into thearticulating joint 368 to lock the joint 368 into a desired position(e.g., at an apex such that the patient support 20 is in the seatedposition). Other mechanisms are possible to accomplish these functions;the pull-pin is just one possible mechanism. The other mechanisms arecontemplated within the present disclosure.

As most clearly seen in FIG. 46, the foot end 65 of the patient support20 is coupled with the H-frame 206 at a through hole near the low end ofthe H-frame 206. The head end 55 of the patient support 20, on the otherhand, is coupled with the H-frame 206 near the top end of the H-frame206. Also as seen in FIG. 46, the pitch assemblies 172 are actuated tomaintain the roll assemblies 174 in coaxially alignment. That is, thepitch assembly 172 on the foot end vertical support 100 is angled upwardand the pitch assembly 172 on the head end vertical support 100 isangled downward relative to each other such that the roll assemblies 174are actively maintained in coaxially alignment with each other.

Reference is now made to FIGS. 47-49, which are, respective, head endisometric, foot end isometric, and side views of an embodiment of thesurgical table 10 with the patient support 20 in Trendelenburg with apartial roll around a longitudinal axis of the patient support 20. Inthis position, the head end vertical support 100 is unextended orvertically extended less than the foot end vertical support 100 suchthat the head end 55 of the patient support 20 is positioned lower thanthe foot end 65 of the patient support 20. In addition to the head end55 of the patient support 20 being positioned lower than the foot end 65of the patient support 20, the patient support 20 is also pivoted,rolled, or rotated about a longitudinal axis of the patient support 20via the roll assemblies 174.

As seen in the FIG. 49, the ladder attachment assemblies 198 and, inparticular, the H-frames 206 are substantially parallel to each other.And, the roll assemblies 174 are in-line such that the axels 196 of theroll assemblies 174 are substantially coaxially aligned. To facilitatethe roll assemblies 174 being coaxially aligned, the pitch assembly 172on the foot end vertical support 100 is angled downward and the pitchassembly 172 on the head end vertical support 100 is angled upwardrelative to each other.

Reference is now made to FIGS. 50-52, which are, respective, head endisometric, foot end isometric, and side views of an embodiment of thesurgical table 10 with the patient support 20 in a partial roll around alongitudinal axis of the patient support 20. In this orientation, thepatient support 20 is generally parallel with the floor and generallyperpendicular with the end supports 100. This position is similar to theneutral position, except the roll assemblies 174 are rotated about thelongitudinal axis of the patient support 20. As seen in the figures, theH-frame 206 and the ladder attachment assemblies 198 are substantiallyparallel to each other, despite the patient support 20 being rolledabout the longitudinal axis. And, the pitch assemblies 172 are similarlypositioned such that the roll assemblies 174 and, in particular, theaxels 196 of the roll assemblies 174 are coaxially aligned.

III. Software Operations of Table and Associated Hardware

FIG. 53 illustrates example operations 800 for articulating a patientsupport 20 in a surgical table 10, as shown in FIG. 1. In oneimplementation, an operation 802 receives input from a user, such asmedical personnel, using a computing device 115, which may be a userdevice generating a graphical user interface on a screen 145 as can beunderstood from FIG. 5 and others discussed above. The input defines anadjustment to an access angle of a surgical field. An operation 804articulates the patient support 20 based on the input using the innerframe 302 on the outer frame 300, the inner frame 302 displaced via thedrive assembly 304 as discussed above. The operation 804 may alsodisplace the patient support 20 by displacing the rigid frame 300 of thepatient support 20 relative to the base 15 of a surgical table 10, asseen in FIG. 1. The motors of the drive and displacement assemblies ofthe patient support 20 and the base 15 of the table 10 may beservo-motors with software synchronization and sensors that all runtogether and independently as directed to maintain the positioning ofthe surgical site relative to the floor during the articulation anddisplacement of the patient via the surgical table 10 of FIG. 1.

The articulation displacement may include various motions, as detailedherein, such as: moving the patient platform outer frame 300 about oneor more pitch axes to and from a neutral position, an extensionposition, or a flexion position; moving the patient platform outer frame300 about one or more roll or vertical axes; translating the patientplatform outer frame 300 cephalad, caudad, patient left or patientright; or causing the patient platform inner frame 302 to displacerelative to the patient platform outer frame 300 to articulate thepatient platform or patient between extension, neutral and flexionpositions. During these articulations and displacements, the operations800 may be such that the surgical field (e.g., the lumbar spine) is keptstable in relation to the floor such that the surgical field does notmove up or down or cephalad or caudad in relation to the floor duringthe articulations or displacements unless the operator purposely intendsthe surgical field to move up or down or cephalad or caudad in relationto the floor during the articulations or displacements. The mechanicalarrangements of the inner frame 302 and outer frame 300, the movementsof the inner frame 302 relative to outer frame 300, and the coordinationof these movements via the operations 800 are such that thearticulations through the extension, neutral, and flexion positions, andvice versa, do not cause compression of distraction of the spine of thepatient 12.

FIG. 54 is a diagrammatic depiction of an example computing system 900wherein the computing system 900 may have one or more computing unitsthat may implement various systems and methods discussed herein.Depending on the embodiment, the computing system 900 may be applicableto the user device 115 of FIG. 5 and others, a server in communicationwith a network, and/or other computing devices. It will be appreciatedthat specific implementations of these devices may be of differingpossible specific computing architectures not all of which arespecifically discussed herein but will be understood by those ofordinary skill in the art.

The computer system 900 may be a general computing system is capable ofexecuting a computer program product to perform a computer process. Dataand program files may be input to the computer system 900, which readsthe files and executes the programs therein.

Some of the elements of a general purpose computer system 900 are shownin FIG. 54 wherein a processor 902 is shown having an input/output (I/O)section 904, a Central Processing Unit (CPU) 906, and a memory section908. There may be one or more processors 902, such that the processor902 of the computer system 900 comprises a single central-processingunit 906, or a plurality of processing units, commonly referred to as aparallel processing environment. The computer system 900 may be aconventional computer, a distributed computer, or any other type ofcomputer, such as one or more external computers made available via acloud computing architecture. The presently described technology isoptionally implemented in software devices loaded in memory 908, storedon a configured DVD/CD-ROM 910 or storage unit 912, and/or communicatedvia a wired or wireless network link 914, thereby transforming thecomputer system 900 in FIG. 54 to a special purpose machine forimplementing the described operations.

The I/O section 904 is connected to one or more user-interface devices(e.g., a keyboard 916 and a display unit 918), a disc storage unit 912,and a disc drive unit 920. In the case of a tablet, a smart phonedevice, or similar computing device, there may not be a physicalkeyboard but rather a touch screen with a computer generated touchscreen keyboard. Generally, the disc drive unit 920 is a DVD/CD-ROMdrive unit capable of reading the DVD/CD-ROM medium 910, which typicallycontains programs and data 922. Computer program products containingmechanisms to effectuate the systems and methods in accordance with thepresently described technology may reside in the memory section 904, ona disc storage unit 912, on the DVD/CD-ROM medium 910 of the computersystem 900, or on external storage devices made available via a cloudcomputing architecture with such computer program products, includingone or more database management products, web server products,application server products, and/or other additional softwarecomponents. Alternatively, a disc drive unit 920 may be replaced orsupplemented by an optical drive unit, a flash drive unit, magneticdrive unit, or other storage medium drive unit. Similarly, the discdrive unit 920 may be replaced or supplemented with random access memory(RAM), magnetic memory, optical memory, and/or various other possibleforms of semiconductor based memories.

The network adapter 924 is capable of connecting the computer system 900to a network via the network link 914, through which the computer systemcan receive instructions and data. Examples of such systems includepersonal computers, Intel or PowerPC-based computing systems, AMD-basedcomputing systems and other systems running a Windows-based, aUNIX-based, or other operating system. It should be understood thatcomputing systems may also embody devices such as terminals,workstations, personal computers, mobile phones, tablets or slates,multimedia consoles, gaming consoles, set top boxes, etc.

When used in a LAN-networking environment, the computer system 900 isconnected (by wired connection or wirelessly) to a local network throughthe network interface or adapter 924, which is one type ofcommunications device. When used in a WAN-networking environment, thecomputer system 900 typically includes a modem, a network adapter, orany other type of communications device for establishing communicationsover the wide area network. In a networked environment, program modulesdepicted relative to the computer system 900 or portions thereof, may bestored in a remote memory storage device. It is appreciated that thenetwork connections shown are examples of communications devices for andother means of establishing a communications link between the computersmay be used.

In an example implementation, table articulation data, imaging data,patient data, a plurality of internal and external databases, sourcedatabases, and/or cached data on servers are stored as the memory 908 orother storage systems, such as the disk storage unit 912 or theDVD/CD-ROM medium 910, and/or other external storage devices madeavailable and accessible via a network architecture. Table articulationsoftware, imaging software, and other modules and services may beembodied by instructions stored on such storage systems and executed bythe processor 902.

Some or all of the operations described herein may be performed by theprocessor 902. Further, local computing systems, remote data sourcesand/or services, and other associated logic represent firmware,hardware, and/or software configured to control operations of the table10 of FIG. 1, the user device 115 of FIG. 5, and/or other computingunits or components in communication with the table 10 and/or the userdevice 115. Such services may be implemented using a general purposecomputer and specialized software (such as a server executing servicesoftware), a special purpose computing system and specialized software(such as a mobile device or network appliance executing servicesoftware), or other computing configurations. In addition, one or morefunctionalities disclosed herein may be generated by the processor 902and a user may interact with a Graphical User Interface (GUI) using oneor more user-interface devices (e.g., the keyboard 916, the display unit918, and the user device 115). The system set forth in FIG. 54 is butone possible example of a computer system that may employ or beconfigured in accordance with aspects of the present disclosure.

In the present disclosure, the methods disclosed may be implemented assets of instructions or software readable by a device. Further, it isunderstood that the specific order or hierarchy of steps in the methodsdisclosed are instances of example approaches. Based upon designpreferences, it is understood that the specific order or hierarchy ofsteps in the method can be rearranged while remaining within thedisclosed subject matter. The accompanying method claims presentelements of the various steps in a sample order, and are not necessarilymeant to be limited to the specific order or hierarchy presented.

The described disclosure may be provided as a computer program product,or software, that may include a non-transitory machine-readable mediumhaving stored thereon instructions, which may be used to program acomputer system (or other electronic devices) to perform a processaccording to the present disclosure. A machine-readable medium includesany mechanism for storing information in a form (e.g., software,processing application) readable by a machine (e.g., a computer). Themachine-readable medium may include, but is not limited to, magneticstorage medium (e.g., floppy diskette), optical storage medium (e.g.,CD-ROM); magneto-optical storage medium, read only memory (ROM); randomaccess memory (RAM); erasable programmable memory (e.g., EPROM andEEPROM); flash memory; or other types of medium suitable for storingelectronic instructions.

The description above includes example systems, methods, techniques,instruction sequences, and/or computer program products that embodytechniques of the present disclosure. However, it is understood that thedescribed disclosure may be practiced without these specific details.

Although various representative implementations have been describedabove with a certain degree of particularity, those skilled in the artcould make numerous alterations to the disclosed embodiments withoutdeparting from the spirit or scope of the inventive subject matter setforth in the specification. All directional references (e.g., distal,proximal, front, back, side, top, bottom, fore, aft, right, left, etc.)are only used for identification purposes to aid the reader'sunderstanding of the implementations, and do not create limitations,particularly as to the position, orientation, or use of the inventionunless specifically set forth in the claims. Joinder references (e.g.,attached, coupled, connected, and the like) are to be construed broadlyand may include intermediate members between a connection of elementsand relative movement between elements. As such, joinder references donot necessarily infer that two elements are directly connected and infixed relation to each other.

It is believed that the present disclosure and many of its attendantadvantages will be understood by the foregoing description, and it willbe apparent that various changes may be made in the form, constructionand arrangement of the components without departing from the disclosedsubject matter or without sacrificing all of its material advantages.The form described is merely explanatory, and it is the intention of thefollowing claims to encompass and include such changes.

While the present disclosure has been described with reference tovarious embodiments, it will be understood that these embodiments areillustrative and that the scope of the disclosure is not limited tothem. Many variations, modifications, additions, and improvements arepossible. More generally, embodiments in accordance with the presentdisclosure have been described in the context of particularimplementations. Functionality may be separated or combined in blocksdifferently in various embodiments of the disclosure or described withdifferent terminology. These and other variations, modifications,additions, and improvements may fall within the scope of the disclosureas defined in the claims that follow.

In general, while the invention has been described with reference toparticular embodiments, modifications can be made thereto withoutdeparting from the scope of the invention. Note also that the term“including” as used herein is intended to be inclusive, i.e. “includingbut not limited to.”

What is claimed is:
 1. A surgical table for supporting and positioning apatient above a floor, the surgical table comprising: a base supportedon the floor and comprising a first end support and a second end supportopposite the first end support; a patient support comprising alongitudinal axis, an outer frame, and an inner frame moveably coupledwith the outer frame at a hinge having an axis of rotation that istransverse to the longitudinal axis, the outer frame comprising a firstend operably coupled with the first end support and a second endoperably coupled with the second end support, the axis of rotation isconfigured to displace in a direction of the longitudinal axis betweenthe first end and the second end when the inner frame articulatesrelative to the outer frame.
 2. The surgical table of claim 1, whereinthe hinge comprises a hinge pin, the axis of rotation extending throughthe hinge pin.
 3. The surgical table of claim 2, wherein the hinge pinis configured to pivot and translate when the inner frame articulatesrelative to the outer frame.
 4. The surgical table of claim 3, whereinthe hinge further comprises a slot configured to receive and guide thehinge pin as it pivots and translates.
 5. The surgical table of claim 4,wherein the slot is defined in the outer frame and the hinge pin iscoupled to the inner frame.
 6. The surgical table of claim 1, whereinthe inner frame comprises an upper leg member and a lower leg membercoupled together at an articulating joint, the upper and lower legmembers being articulable relative to each other at the articulatingjoint.
 7. The surgical table of claim 6, further comprising a driveassembly configured to: displace the inner frame relative to the outerframe about the hinge, and articulate the upper leg member relative tothe lower leg member about the articulating joint.
 8. The surgical tableof claim 7, wherein the drive assembly comprises at least one motorcoupled to a link arm coupled to the inner frame, wherein the link armis configured to transfer forces from the motor to the inner frame tobring about displacement of the inner frame relative to the outer frameand to bring about articulation of the upper leg member relative to thelower leg member about the articulating joint.
 9. The surgical table ofclaim 8, wherein the at least one motor comprises a first motor and asecond motor, the first motor coupled to the link arm and configured torotate the link arm, the second motor operably coupled with the firstmotor and configured to translate the first motor along a linear path.10. A surgical table for supporting and positioning a patient above afloor, the surgical table comprising: a base supported on the floor andcomprising a first end support and a second end support opposite thefirst end support; a patient support comprising a longitudinal axis, anouter frame, an inner frame moveably coupled with the outer frame at ahinge having an axis of rotation that is transverse to the longitudinalaxis, and a drive assembly, the outer frame comprising a first endoperably coupled with the first end support and a second end operablycoupled with the second end support, the inner frame comprising an upperleg member coupled with a lower leg member at an articulating joint, thedrive assembly comprising at least one motor configured to displace theinner frame relative to the outer frame and articulate the upper legmember relative to the lower leg member.
 11. The surgical table of claim10, wherein the drive assembly further comprises a link arm operablycoupled between the at least one motor and the inner frame member. 12.The surgical table of claim 11, wherein movement of the link arm causesthe inner frame to displace relative to the outer frame and the upperleg member to articulate relative to the lower leg member.
 13. Thesurgical table of claim 11, wherein the at least one motor comprises afirst motor and a second motor, the first motor coupled to the link armand configured to rotate the link arm, the second motor operably coupledto the first motor and configured to translate the first motor along alinear path.
 14. The surgical table of claim 10, wherein, when the innerframe articulates relative to the outer frame, the axis of rotation ofthe hinge is configured to displace between the first end and the secondend of the outer frame.
 15. The surgical table of claim 10, wherein thehinge comprises a hinge pin configured to pivot and translate betweenthe first end and the second end of the outer frame when the inner framearticulates relative to the outer frame.
 16. The surgical table of claim15, wherein the hinge further comprises a slot configured to receive andguide the hinge pin as the hinge pin pivots and translates.
 17. Thesurgical table of claim 15, wherein the slot is defined within the outerframe and the inner frame comprises the hinge pin.
 18. The surgicaltable of claim 10, wherein the drive assembly is coupled to the outerframe in between the first and second ends of the outer frame.
 19. Thesurgical table of claim 10, wherein the lower leg member is guided by aportion of the outer frame when the upper and lower leg membersarticulate relative to each outer about the articulating joint.
 20. Thesurgical table of claim 19, wherein the portion of the outer frame is amulti-tiered surface near the second end of the outer frame.
 21. A basefor supporting a patient support structure of a surgical table, the basecomprising: a first end support and a second end support opposing thefirst end support, each of the first and second end supports configuredto vertically extend and retract, the patient support structure coupledwith the first end support via a first connection assembly including afirst roll assembly and a first pitch assembly, the patient supportstructure coupled with the second end support via a second connectionassembly including a second roll assembly and a second pitch assembly,the first and second roll assemblies configured to roll the patientsupport structure about a roll axis positioned above a longitudinal axisof the patient support structure, the first and second pitch assembliesconfigured to actively maintain coaxial alignment of the first andsecond roll assemblies by angling the first and second roll assembliesupward or downward when the first and second end supports changeelevation relative to each other.
 22. The base of claim 21, wherein eachof the first and the second pitch assemblies include at least one lineardrive to actively maintain the coaxial alignment.